title: Predictive markers of response to isotretinoin in female acne.
abstract: BACKGROUND
  Acne vulgaris is a common and chronic disorder of the pilosebaceous unit. Female acne may be a subtype differing from teenager acne. Isotretinoin is the only therapy impacting on all the major acne-related aetiological factors. All clinical studies demonstrating isotretinoin efficacy in acne patients have been performed either in teenagers or in a mixed population of teenagers and adults.
  
  
  OBJECTIVE
  To evaluate isotretinoin efficiency and tolerance in a cohort of females with acne, aged 20+ years.
  
  
  METHODS
  Study of 32 women prescribed isotretinoin according to the European recommendations (0.5 mg/kg) in two dermatology departments (France and Greece). The ECLA scale and a global evaluation using the GEA grading were used to evaluate isotretinoin efficacy. The correlation between the clinical response and the different epidemiological factors was determined.
  
  
  RESULTS
  Complete response reached 59% on the face, 78% on the trunk and 43% on both the face and trunk. A significant correlation was observed between the facial response and body mass index (p = 0.02), the high-glycemic-load diet (p = 0.0009), tobacco (p = 0.05) and age at acne onset (p = 0.05).
  
  
  CONCLUSIONS
  Isotretinoin at 0.5mg/kg is effective and well tolerated in mild-to-moderate acne in females over 20 years old and results were similar to those of teenagers and men. We can propose positive predictive markers of response to isotretinoin in female acne, including a low body mass index, low glycemic-load diet, no tobacco, absence of early acne onset and of lesions on the neck.
authors.affiliation: Department of Dermato-Cancerology, CHU Nantes Hotel Dieu, 1 place Alexis Ricordeau, 44000 Nantes, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Preneau
authors.forename: Clio
authors.initials: C
authors.lastname: Dessinioti
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Nguyen
authors.forename: Andreas
authors.initials: A
authors.lastname: Katsambas
authors.forename: Brigitte
authors.initials: B
authors.lastname: Dreno
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy* / Q000453:epidemiology; D000328:Adult; D017668:Age of Onset; D015992:Body Mass Index; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D050528:Diet, Carbohydrate-Restricted; D005260:Female; D006801:Humans; D015474:Isotretinoin / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D012907:Smoking; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin